What men can do to reduce their partner's risk of postpartum depression

Men, not hormones, are the main thing destroying women's postpartum mental health. But you can protect her. And there's no excuse not to.

The leading cause of postpartum mental health issues isn’t hormones. It’s male partners. Social support is the single most important predictor of postpartum mental health. In most heterosexual marriages, the men not only fail to provide adequate support; they actively undermine their partners’ well-being.

That might seem like radical feminist indoctrination, but it’s actually well-supported by the research, which consistently shows that marital dissatisfaction, abuse, and lack of social support—not crazy woman hormones, sorry—are the leading cause of postpartum depression. Bad treatment during the postpartum period isn’t just common; it’s normalized and dismissed, as evidenced by a million comics that laugh about men who sleep through the night as their partners spiral into increasingly desperate levels of exhaustion. Factor in the horrible treatment the typical mother faces, and it’s a miracle we’re not all depressed.

My own data on postpartum experiences show that abuse is the default for people recovering from childbirth. Maybe instead of telling women to take a pill and get some therapy so they can learn to live with the unacceptable circumstances in which we expect them to mother, we should advise them to seek a divorce instead.

If you’re the partner of a pregnant person, you are the main thing standing between them and a million sleepless, tear-filled nights. You can’t compensate for an entire society that abuses women, and you can’t singlehandedly become the village. But you can do a lot.

And you should.

Because becoming a mother in the United States (and, frankly, most other places in the world) means putting your life on the line for someone else. It means entering a dangerous abusive childbirth system, then doing whatever it takes, for months, no matter what, to support your baby as you recover from birth.

Women don’t get to go on a self-discovery journey while someone else does the work. They don’t get to take their time learning how to parent. They are expected to do it no matter what—and no matter how they do it, society gleefully tells them it’s wrong, and that they’re entitled monsters for expecting anything other than abuse and neglect.

We have no problem asking women who have just had a major medical event to completely quit sleeping indefinitely. Why is it that we’re so uncomfortable asking men to do anything at all?

And why is it that the men who claim to love these women, who have watched these women call forth human life, are so unwilling to do much?

It’s because we don’t think women count.

But you, dear reader. You don’t want to be like that, do you? You want to see your partner through this. You want to show your gratitude for the sacrifices she’s making for your family. You want her to come out on the other side of this fully whole and healthy.

You’re not like all those other men. And to truly not be like them, you’re going to have to put in some work.

Every marriage is different and every postpartum person is different. But a few simple principles can help you help your partner:

Understand what the postpartum period really is

Imagine you’ve just had major surgery. You’re in pain. You can barely walk. What sort of help are you going to need to get through the next couple of days or weeks?

Start from that premise as you consider how best to help your partner. She is in recovery. She should not be doing things for you. And if you’re doing half of the parenting and housework, you’re not doing enough. After all, if you just had liver surgery, how would you feel if you had to come home and do half the cleaning?

Postpartum recovery is about more than the physical, though. Giving birth is a life-changing experience. Whether your partner is a committed natural birther, an epidural lover, or something else entirely, birth matters. How your partner feels and is treated during this period will color her perceptions of herself as a mother, a partner, and a human being forever.

And if you mistreat her? She will never, ever forget it. And your relationship will never be the same.

You get one chance to get it right. Treat this with the gravity it demands.

Talk to her about her support needs ahead of time

All birthing people deserve love and support. But what that means varies greatly from person to person. Maybe it’s really important to your partner to have a natural birth, and she needs you to help her achieve that. Maybe she believes birth is a spiritual experience, and she wants help to build a birthing space that feels sacred. Maybe she’s scared shitless. You don’t know unless you ask.

Spend as much time as you can planning for her birth and for the postpartum period. Consider setting up a weekly appointment to discuss it. And then, be present. Really, really listen to what she needs. Ask her to identify her most important needs from you. Then be prepared to meet those needs.

Be there for her during birth

Birth is unpredictable. But research consistently shows that lack of support produces worse outcomes and, regardless of the outcome, it makes the birthing person feel worse about their experience.

I know one woman whose partner told her “This is the hardest day of my life” in the middle of their son’s birth. I know another who slept through the entire birth. And I know several whose partners consistently whined about their own physical discomforts, or complained about how gross birth is.

What do these women share in common? They all ended up with postpartum mental health issues. Because their partners took a sacred, life-changing moment and desecrated it.

Don’t be that guy.

Some tips for being fully present during the birth include:

• Be awake, alert, and happy. No whining. No complaining. No negativity, anger, or bad attitudes. You can get through a few days of fatigue if it means giving your partner a birth experience she can feel positive about.

• Do not sleep unless your partner says she is ok with it, and actually is ok with it. This means you don’t get to guilt her into letting you sleep, or act like such an asshole that she’d rather you be asleep than present.

• Know that no matter how scary this is for you, it’s scarier for her. You have to be the rock. Fake it if you have to.

• Be on her side. Always. Don’t let your family, your doctor, a nurse, or anyone else bully her. You are her ally and her partner, and nothing and no one should come between you.

• Praise her. Admire her strength. Honor her. No matter how she gives birth, she is doing one of the most difficult things a human being can do. Make her feel good about it.

• Celebrate her after the birth. Give her flowers, a card, a love letter, a push present. Something. She has triumphed and made it through. That is worthy of celebration.

• Protect her sacred space. Let her bond with the baby. Don’t allow people to intrude. And remove anyone who criticizes or demeans her (even if they’re the doctor).

Support her to recover

At minimum, your partner is going to need the following to recover and thrive after giving birth:

• Sleep: Humans cannot thrive without sleep. And at a certain point, they cannot even function. Her status as a new parent does not render her superhuman. If your partner is not getting enough sleep, she cannot be ok. You need to get up with the baby. If that is not possible, you need to give her plenty of breaks to sleep during the day. Nothing excuses this duty. It doesn’t matter if you have to work. She has to care for a baby. And if you expect her to care for a baby in a state of sleep deprivation, you must be prepared to work while sleep deprived.

• Food: She can’t breastfeed without adequate nutrition. She can’t recover without adequate nutrition. Make her food. Buy her food. Get her food. If she is breastfeeding, feed her something every time she nurses the baby. It is not her job to feed you right now; it is your job to feed her.

• A physically comfortable and safe space: Few people can be comfortable in a dirty house where they have no comfortable space to relax. Keep the house clean. And if you can’t do that, keep a cozy space for her. Your partner needs to be able to settle into her nest with the baby. Don’t even think about asking her to clean the nest up.

• A low-stress environment: Your home must feel like a safe place. This means no visitors who abuse or undermine your partner. Even if they’re faaaaamily. You are her buffer against stress. Keep the home quiet, relaxing, and free of unhelpful people.

• Support for her parenting choices: Do whatever you can to support your partner’s parenting choices. If she wants to breastfeed, call the lactation consultant and tell anyone who shames her to get the fuck out of the house. Now is the time when your partner establishes herself as a mother. Help her feel good about herself and confident in her decisions.

Your partner is also going to need physical care. She may need help with basic self-care tasks. She might need you to help with sitz baths or other tasks. Make her feel loved, not judged, when you help.

Prepare for the Baby Blues

Postpartum depression is not exclusively hormonal, but the baby blues are. During the first couple of weeks following birth, your partner is going to have some emotional swings. These leave her in a vulnerable emotional state. She may be fearful, sensitive, or cry easily. This is normal.

Now is your chance to show that you can support her. And in so doing, you’ll help her feel safe in a way that can buffer against longer term mental health issues. Love her. Listen to her. Never judge her. And for God’s sake, don’t leave her alone if at all possible. Isolation is incredibly bad for people recovering from birth.

Provide emotional care

Your partner has a lot to process—their birth, their pregnancy, how they feel about each. And everyone is different. In general, here is what most people need:

• Ask her about her birth. Encourage her to talk about it. More than once.

• Listen attentively and responsively to whatever she says.

• Be gentle with her. Do not criticize her. Apologize when you are wrong.

• Give her extra physical affection. Hugs, massages, loving support.

• Spend as much time with her as possible. Do all you can to relieve her stress.

• Reassure her that you are proud of her, that she is doing a good job, and is a great mother.

Be her advocate

Now that you and your partner are parents, you are bound together for life, like it or not. This is a whole new level of partnership. Start it off right by behaving as a loving partner, who puts his partner first. Your mother doesn’t win. Your friends don’t win. The person who brought your child into this world must have your first loyalty, and must be your priority. Anything less will have lasting, and potentially catastrophic, emotional reverberations.

Be a good parent

No matter how nice you are, if your partner can’t trust you with the baby, it’s going to undermine her mental health. Learn all you can. Be attentive and protective. Spend time with the baby. Get up with the baby. Go to the pediatrician appointments.

At the end of your life, you will look back on this period as one of the most important of your life. Your friends, your job, your sleep will all matter little. Make this time count. You’ll never get it back. Love your partner and child, and watch your life gain new purpose and meaning. Neglect them at your peril.

Don’t be a fucking asshole

Being an asshole during this vulnerable period has a much higher cost. So stuff it. Never do the following:

• criticize or demean her parenting

• dismiss her emotions

• emotionally abuse her or call her names

• pressure her into sex

• side with others against her

• criticize her body

• pressure her to lose weight

Some things are unforgivable. Mistreating the person who has just brought life into the world for your family is among them. Remember above all else that she will remember how you treat her during this time till she takes her last breath.